Symptoms
Pain in the ankle joint can be classified more precisely according to various points: Depending on the cause of the pain in the ankle joint, other symptoms appear together and provide indications of the severity of the injury or disease. For example, if you have twisted your ankle, it hurts immediately and swells up, and it can also be red. If the ankle is bent, blood vessels can burst, which can cause a hematoma after a few hours.
If the ankle is slightly injured by a twist, the ligaments are only overstretched, and the occurrence with the foot is then painful but possible. If ligaments are very severely overstretched or even torn, affected patients feel a feeling of instability and insecurity in the ankle joint. In some cases, if a ligament is torn, the foot can be moved beyond its natural limits.
Injury to the ligamentous apparatus of the ankle joint can lead to chronic instability of the ankle joint: Patients complain of an ever-present feeling of insecurity in the ankle joint, have pain during prolonged strain and bend over more frequently than others. When the outer or inner ankle is broken, a hematoma forms over the broken ankle, and when pressure is applied, the pain increases. Possibly the broken bones or a gap between the bones can be felt or a crunching sound can be heard.
The range of movement of the ankle joint is limited by the pain when the ankle is broken. In the case of a fractured heel bone, the pain is usually so severe that standing and walking are impossible. If, after an injury, the foot is offset to the side of the lower leg, a fracture of the ankle joint fork may be the cause.
Overheating of the ankle joint can be an accompanying symptom of an injury to the ankle, but especially when the pain has occurred without a triggering event, it provides an important indication that the joint may be inflamed or affected by a gout attack. This article may also be of interest to you: Torn ligament in the foot – what to do? Torn foot ligament Loading after ankle fracture In some cases, a torn ligament can cause the foot to move beyond its natural range.
An injury to the ligament apparatus of the ankle joint can lead to chronic instability of the ankle: Patients complain of an ever-present feeling of insecurity in the ankle joint, have pain during prolonged strain and bend over more frequently than others. When the outer or inner ankle is broken, a hematoma forms over the broken ankle, and when pressure is applied, the pain increases.Possibly the broken bones or a gap between the bones can be felt or a crunching can be heard. The range of movement of the ankle joint is limited by the pain if the ankle is broken.
In the case of a fractured heel bone, the pain is usually so severe that standing and walking are impossible. If, after an injury, the foot is offset to the side of the lower leg, a fracture of the ankle joint fork may be the cause. Overheating of the ankle joint can be an accompanying symptom of an injury to the ankle, but especially when the pain has occurred without a triggering event, it provides an important indication that the joint may be inflamed or affected by a gout attack.
This article may also be of interest to you:
- Exact localization, strength and quality (e.g. stabbing), duration (since when? ), course (always there? Only under stress?
Only during a certain movement? Only at rest?) and triggering event, such as bending over or a traffic accident.
- Other symptoms of ankle pain are: Haematomas (bruises), redness, swelling, overheating of the joint, malposition or limited range of motion.
- Torn ligament at the foot – what to do?
- Torn ligament foot
- Stress after an ankle fracture
Pain on the inside of the ankle joint is often observed after an inward twist.
In the case of a slight injury, only the inner ligament, which is also called the deltoid ligament, is overstretched. The delta ligament consists of several parts and runs from the inner ankle to the sole of the foot. The overstretching causes pain and a slight swelling, possibly also a hematoma.
The stretched ligament usually heals within a few days. In the case of a moderately severe injury, one or more parts of the deltoid ligament are torn. The ankle joint hurts, swells and is slightly unstable.
A severe injury can lead to a complete rupture of the deltoid ligament and thus to complete instability of the ankle joint. In very severe cases, the inner ankle may break and even the outer ankle may be involved. Pain on the inside of the ankle joint can also be caused by an injury to the scaphoid, which is part of the lower ankle joint.
The tendons of the deep calf muscles (M. tibialis posterior, M. flexor hallucis longus, M. flexor digitorum longus), which are responsible for turning the foot inwards and bending the ankle towards the sole of the foot, run past the inner ankle. The three tendons of the deep calf muscles run in tendon sheaths along the inner ankle. Pain in the ankle joint can therefore also be caused by overloading these tendons or by tendon sheath inflammation.
Pain on the outside of the ankle joint is often caused by an outward twist, the supination trauma. The supination trauma is the most common sports injury, especially footballers, volleyball players and other ball sportsmen are affected. Hikers and joggers also often bend over outwards due to uneven surfaces.
Slight pain after bending over is often harmless because the outer ligament has only been overstretched. Appearance and running are unpleasant, but possible. After a few days, the foot is painless and fully functional again.
Stronger pain indicates a more severe injury: The outer ligament may be torn or torn (more information on torn ligaments can be found in the article: Torn foot ligament): The outer ligament of the ankle joint consists of three parts. When the ankle is bent, the ligamentum fibulotalare anterius, which runs from the outer ankle to the ankle bone, tears most frequently. Serious injuries often result in a fracture of the ankle joint, which is divided into Weber A, B and C fractures.
Behind the outer ankle, the tendons of the M. fibularis longus and M. fibularis brevis run along their own tendon sheaths. These muscles are responsible for turning the foot outwards and for bending the ankle joint towards the sole of the foot. Overloading these tendons or an inflammation of the tendon sheath can also cause pain in the outer ankle.
You can find exercises for this in the article Exercises in case of tendosynovitis. Pain in the ankle joint when running can be caused by a previous injury, regardless of whether it is a ligament stretch, a torn ligament or a broken bone. Pain in the ankle joint, which occurs “just like that” when running, has other causes: If the wrong shoes are worn (for example, simple sneakers for longer jogging) or if new shoes have not yet been broken in properly, the ligamentous apparatus of the ankle is overstrained, which can cause pain.Another cause is overloading of the tendons that run around the outer and inner ankle, or inflammation of the tendon sheaths in this area.
A common cause of pain in the ankle joint when walking is arthrosis of the ankle. Osteoarthritis describes joint wear that is excessive for the age of the patient: heavy strain, incorrect loading, overweight and past injuries increase the risk of increased wear and tear of the joint. The protective layer of cartilage gradually breaks down in osteoarthritis, and at some point pain inevitably ensues because this protective layer is lost and the bones involved in the ankle rub against each other.
The pain is then clearly felt, especially when walking. Special foot gymnastics can be used to prevent this. You can find information on this in the article Physiotherapy exercises ankle joint.
Pain in the ankle joint above affects the area at the transition from the back of the foot to the shin. In this area are the lower part of the tibia and the ankle bone, injuries of these bones can cause pain in the ankle joint above. Pain in this area can also be caused by injured ligaments.
About 1.5% of people have an additional bone in this area, the dorsal talonavicular bone, which is located between the ankle bone and the scaphoid. In most cases it does not cause any problems, rarely it can cause inflammation of the adjacent tendons. The tendons in this area belong to the muscles of the extensor group on the lower leg (tibialis anterior, extensor digitorum longus, extensor hallucis longus), which are responsible for pulling the toes towards the lower leg.
The tendons of these muscles run along the back of the foot in tendon sheaths, which can become inflamed as a result of overloading (e.g. by an additional dorsal talonavicular os talon). Pain in the rear ankle joint after a fall from a great height or after traffic accidents suggests a fracture of the calcaneus, with the rear foot being thickly swollen and painful. A double ankle fracture (broken inner and outer ankle) can also lead to a shear fracture at the rear edge of the tibia (posterior Volkmann triangle), which is then referred to as a triple ankle fracture.
Therapeutic measures can be found in the article Exercises Ankle fracture. Another cause is the rupture of the Achilles tendon, which is pre-damaged in patients with rheumatism, high uric acid levels, or taking cortisone, and tears more quickly than in healthy patients. In the moment of the rupture one feels a tearing pain and hears a popping noise, afterwards a dent is palpable and the rear ankle joint is swollen and pressure-painful.
Particularly in runners, the Achilles tendon is severely irritated by an inward twist. In most cases, the irritation remains. The Achilles tendon should then be well stretched and taped.
Pain in the ankle joint that suddenly occurs at night is most likely due to a gout attack. The joint swells, becomes hot and discolors reddish to bluish. A gout attack is very painful: even the slightest touch can be painful.
In the morning, the haunting is usually over again. The ankle joint is the second most frequently affected by gout after the joint of the big toe with 14% of gout attacks. Gout is caused by a disturbance in the urea metabolism, which causes too much uric acid to remain in the blood and then be stored as uric acid crystals in joints, tendons and kidneys. These uric acid crystals cause severe pain and if the gout is not treated, permanent inflammation and deformation of the joints occur.